T2Candida enabled the detection of candidemia 29 hours before a positive blood culture was returned. Early detection allowed for the rapid initiation of antifungal therapy in a critically ill COVID-19 patient.
Lee Health | Fort Myers, Florida
Patient History
Age and Sex: Elderly Male
History: Patient was admitted to the hospital with confirmed COVID-19. His past medical history included Type 2 diabetes mellitus and hypertension
Presentation: The patient required oxygen support via nasal cannula. A chest radiograph showed bibasilar infiltrates and initial blood cultures were negative.
Risk Factors: The patient had multiple risk factors for candidemia during hospitalization.
- Presence in ICU
- Broad-spectrum antimicrobial therapy
- Immunosupressing medications
Evaluation and Treatment
Day 1
The patient was initiated on azithromycin and methylprednisolone, was given one dose of convalescent plasma
Day 2
Patient was administered 1 dose of tocilizumab (8mg/kg)
Day 3
Patient was intubated for worsening respiratory status
Day 14
Patient developed new fever, chest x-ray showed increased opacities, broad-spectrum antimicrobial therapy was initiated for suspected bacterial pneumonia
Day 15 & 16
Fever escalates (Tmax 101.9F and 103F, respectively). Additional blood cultures were obtained and T2Candida was ordered. T2Candida was positive for Candida albicans/Candida tropicalis 29 hours before the positive blood culture. On the evening of day 16 anidulafungin was initiated
Day 18
Patient defervesced
Day 30
Patient was discharged to a long-term acute care center
- Cubillos, A., et al. CAP, 2021